study of tumor rna disruption assay™ (rda)

Conditions: Breast Neoplasms

Summary: the purpose of this study is to find out if the pathological complete response (pcr) to chemotherapy given before surgery (neoadjuvant chemotherapy) could be predicted by the evaluation of the rna (ribonucleic acids) disruption pattern (rna disruption assay or rda score) obtained from a biopsy of the tumor 7 - 14 days after the first, second and third cycles of chemotherapy treatment. if we can determine the optimal time during neoadjuvant chemotherapy to measure the rda score for the prediction of pcr, we can optimize breast cancer management.

when administering neoadjuvant chemotherapy, the current practice of monitoring response to treatment is by measuring the size of the breast tumor after each cycle of chemotherapy. the drawback to this method is, it will take several weeks before we can actually measure a significant change in size; and the initial response to chemotherapy is often evident as a softening of the tumor without an apparent decrease of the tumor size. finding a reliable way to identify early response to chemotherapy would be helpful to enable matching of chemotherapy to an individual's need. in a previous trial of breast cancer treated with neoadjuvant chemotherapy, researchers have identified that the pcr to a full treatment of chemotherapy could be predicted by the change in rna pattern obtained from a biopsy of the tumor half way through the chemotherapy course. \[parissenti et al. 2010\] the purpose of this study is to determine if we can predict the pcr to neoadjuvant chemotherapy by examining the pattern of rna disruption (rna disruption assay or rda score) from breast biopsy tissue obtained 7 to 14 days after the first, second and third cycle of chemotherapy. if we can determine the optimal time during neoadjuvant chemotherapy to measure the rda score for the prediction of pcr, we can optimize breast cancer management. for example, if rda score can identify non-responders earlier, we can switch to other chemotherapy agents and reduce the exposure to the unnecessary side-effects of ineffective treatment.

Eligibility criteria:
inclusion criteria: * female,18 years or older; * able to read and write in english: * with palpable cancer \> 2cm (t2, t3) on clinical examination or clinical diagnosis of locally advanced breast cancer (labc) (t3 or t4; or n2 or n3, according to tnm cancer staging including inflammatory breast cancer); * must have histological proof of breast cancer (invasive ductal or infiltrating lobular); * scheduled to receive neoadjuvant chemotherapy as part of their treatment plan; * agree to have fnab after the first, second and third cycle of chemotherapy, and if the chemotherapy regimen is changed, an additional fnab after the first cycle of the new chemotherapy. exclusion criteria: * subjects who have had surgery, neoadjuvant chemotherapy or radiotherapy for the current breast cancer; * subjects who are pregnant or breast feeding; * subjects with stage iv breast cancer; * psychiatric or addictive disorders that may limit the ability to give informed consent or complete the trial.

Keywords: breast cancers neoadjuvant chemotherapy rna disruption assay™ (rda) score pathological complete response (pcr) fine needle aspiration biopsy